How does Zyprexa work in terms of weight gain?

[Cleansing]

I'm considering switching from Zyprexa to something else, but if Zyprexa isn't the problem, then I rather keep it because it makes going to sleep pretty easy. Plus I don't hallucinate anymore.

There's too things happening since I started the Zyprexa. One is that I eat a lot, and another is that I'm gaining a lot of weight.
(1) I can't tell if I'm eating so much as a result of the Zyprexa, or if it's "emotional" eating.
(2) I can't tell if I'm overweight because of the Zyprexa messing with my metabolism or if it's because my diet/workoput plan isn't good enough. I stick to my diet pretty good, but once I take my Zyprexa at night, it hurts too much not to pig out. Anybody know why that is?

I'm a male, 5 Feet 9 inches, 190 pounds. I'm normally 165 pounds, and I want to get somewhere between 175-180.


Suggestions about medications? Is it the med?

I might go back to Seroquel. That has no weight gain apparently (it never did for me) and it helps with hallucinations. My problem with Seroquel is that I'm always tempted to mix it with alcohol or DXM and I'm a recovery addict.

[pedagogue]

Scientists have some ideas about why certain meds encourage weight gain, though they have highlighted a few factors they point to (metabolism changes, increased appetite, food 'cravings', etc). HERE* are a few good slides from the CATIE study that talk about metabolism and weight gain in regard to some popular anti-psychotics. The gist of the findings is that Zyprexa/Olanzapine patients in the study gained more weight on average compared to other meds tested. The slides and explanation can be wordy, but I thought the graphs were pretty good at showing there were some differences in the findings. You can google the full CATIE study or the synopsis if you are interested in why/what they were studying. Just be careful generalizing their findings, because there are a lot of variables that can effect what they found when applying to an individual.

-edit-

*I just realized you'll need a Medscape (free) login to view the full article & slides. I copied two slides and one description below, though the full explanation is available through the link.

Looking at changes in weight, we can again now graphically depict what you saw in some numeric tables from Dr. Lieberman. We can look at mean change in baseline weight on the top panel -- and this is last observation carried forward -- with about 9 pounds. This is very similar to what's been shown in other studies: a 9-pound gain on olanzapine; less gain on quetiapine and risperidone (somewhere around 1 pound). But here you see an interesting phenomenon; you're actually seeing weight loss in some of the treatment arms on the perphenazine and ziprasidone arm, and I don't think anyone's properly concluding from CATIE that ziprasidone or perphenazine is a weight loss drug. It's more a question of what were these individuals taking before, and if they've now switched or been randomized to something that has less drive on appetite, or curb on satiety, that you may actually see drops in weight.

On the bottom panel, you see the number of patients who achieve this criteria of a greater than or equal to 7% increase in body weight. This is a metric that the Food and Drug Administration uses and is typically included in the US package insert. You see very consistent with US package insert numbers; about 30% of patients taking olanzapine achieve this criteria for weight gain; about 16% on quetiapine; 14% on risperidone; 12% on perphenazine, and 7% on ziprasidone. Notice ziprasidone with 7% of the patients achieving a greater than or equal to 7% increase in body weight. Ziprasidone can be understood to cause some degree of weight gain, but it's in this top panel that you see the mean change was still in the negative direction.

Zyprexa can be a very effective med, though there will always be trade-offs. Many anti-psychotics can cause weight gain, so it can be a 'grass is always greener' scenario sometimes. Some may be less likely (Abilify for example), but in the end it depends on the person. Your psychiatrist is the best person to address side effect concerns and effectiveness of medications. There are some anti-psychotic meds that have less weight gain issues (on average), though there are other/different downsides to them. There are some things that can help with the side effects, though they can be different for each person: nutrition changes, additional med to address certain side effects, etc.

Best of luck.

[barb dwyer]

I hate to be the one to throw a wrench in any works or anyting, but ...

When I got put on anitdepressants -
it was around the same time my thryoid began shutting down.
I experienced what I consider extreme weight gain during that time as well.
I understand what you're describing as a kind of unstoppable munchie-hunger...
which I NOW understand was my body screaming for energy
that it USED to get though food.

I just finished reading this book on hypothyroidism, by Mary Shomon.

I think it doesn't matter now what happened first
thyroid disease or antidepressants
Because this book helped me understand that it is amazingly COMMON for early thyroid disease to be misdiagnosed.

And no matter what I did, or didn't do -
I could not lose a single pound,
and to top it off - continued to gain.
Adding insult to injury.

I am not saying that I know this might apply to you - not at all.

But if I can save anyone the discomfort and misery I've just gone through - for almost two years before a diagnosis- I'm going to try.

[Easeful]

My son gained 50 pounds the 6 weeks he was on zyprexa. He ate like a horse. Unfortunately as far as determing the true cause he was also on lithium for that same 6 weeks and it completely suppressed all thyroid function. So we'll probably never know. I'm a big fan now of making one med change at a time.

[barb dwyer]

Easeful -
thank you so much for the post -
I was feeling that I'd overstepped my boundary or something -
I SOOOO gratefully read your post.

thank you for that.

[kcal]

I would look into the coorelation between seritonin and those medications you are/were taking. I just read a book, "The Power Seritonin Diet," and it suggests strong links to one another through research and studies. Good luck.
Kcal

[Done_With_It]

Originally Posted by Easeful

My son gained 50 pounds the 6 weeks he was on zyprexa. He ate like a horse. Unfortunately as far as determing the true cause he was also on lithium for that same 6 weeks and it completely suppressed all thyroid function. So we'll probably never know. I'm a big fan now of making one med change at a time.

If I had kept taking zyprexa this would have been my experience.
I hear it is a GREAT med if it works for you. It just did not work
for me with the weight gain...

[Cleansing]

I love Zyprexa because it makes sleep so easy and pleasant. It's not like Trazadone, which gave me this inebriated , sort of loss-of-control feel before I slept. That was very uncomfortable. Zyprexa just chills me out so I can sleep whenever I'm ready to call it a night. It also seems to keep me stablized during the day (I'm also on Depakote, Effexor, and Wellbutrin, they all help).

BUT, this weight gain is becoming a problem for me. Now that it's very noticeable, I want to extra fat gone. Which is why I am going to ask my psycdoc about going back on Seroquel. Seroquel seems to create weight gain for some people, but when I was on it before, I was not getting bigger. The two main reasons why I stopped taking the Seroquel were (1) I didn't want to be on so many meds -- I was on 6 meds in total at the time (2) It kicked up my gravings to use Alcohol and DXM.

Abilify is out of the question because I got real sick the three days I was on it.
Other anti-psychotics don't have the sedating effect that I need.

It's either Seroquel or Zyprexa. I have my appointment with my doctor at 1pm today, I'll mention all of this to him.

As for the thyroid, I just recently took a blood test, the results come in next week. Thyroid disease does run in my family though.

[barb dwyer]

[QUORTE]As for the thyroid, I just recently took a blood test, the results come in next week. Thyroid disease does run in my family though. [/QUOTE]


Thanks for that Cleansing - glad for the update.

I don't want to become one of those 'oh man there she goes' kind of people, but like I say if I can avert anyone the misery the last year has been for me, I'm gonna try.

thanks again!

[Cleansing]

Update

I decided not to lie to myself. Ater talking with my doctor, I realized that Zyprexa is something I need both for my mental health and my sobriety. For my mental Health because I begin to bug out at night without it. Sleeping is something I dread, and the anxiety over finishing one day and starting a new one is quite high. I can't really explain what it is, but basically, I can't stand ending a day, I never feel like I've done enough that I can be happy with. I feel like I live life, but that I'm rarely happy during the days. And I cannot stand to live another day of the same nonsense. Zyprexa calms me down, so it takes away these thoughts and allows me to enjoy some relaxation before I sleep. Also, i take 2.5 mg in the morning whenever needed to give me soem extar peice of mind.

It helps with my sobriety because other meds like Trazadone and Seroquel go great with DXM, Alcohol, and opiates (I always thought) so they are triggers. Plus Seroquel wasn't as effective as Zyprexa to be honest.

In conclusion
I'm gonna have top deal with the weight gain because I need Zyprexa. I'm not strong enough to get off it yet.
It's hard, but I'm getting the hang of dieting. I've even seen a dietician.